Driver Licensing

Guideline No. 13 recognizes the importance of the driver licensing authorities’ (DMV) to legally restrict or suspend an individual’s license, especially if an individual has a medical condition that affects their driving capacities.  Specifically, the Guideline encourages DMVs to make individualized determination of fitness to drive, based on the review and assessment of an individual’s capacities to safety operate the motor vehicle. 

In North Carolina (NC), the Medical Review Unit Program (MRU) mission is to evaluate the driving fitness of individuals with medical conditions that adversely affect their ability to safely operate a motor vehicle.  NC’s MRU follows the Guideline. When it is unclear whether a driver is unfit to drive, the MRU requires the driver to get a comprehensive driving evaluation. 

A comprehensive driving evaluation is a thorough evaluation in an occupational therapist / driving rehabilitation specialist (OT-DRS) assesses an individual’s driving knowledge, skills, and abilities. The comprehensive driving evaluation typically includes medical and driving histories; evaluations of sensory-perceptual, cognitive and psychomotor functional abilities; and, an on-road evaluation, if necessary.    

In North Carolina, there are only a limited number of OT-DRSs in the state, found on this list.  Because of the limited number, a major outcome of this project was to improve access to the comprehensive driving evaluations.   

Collaborative Model for Comprehensive Driving Evaluations

To meet the demand for evaluation of medically-at-risk drivers. 

This was a multi-step process of: 

1. Building a model that delivers a quality comprehensive driving evaluation without the extensive education and training typically needed by an OT-DRS.
2. Experienced occupational therapists and driving instructors were brought together for hands-on education over a series of workshops.
   • The occupational therapist focused on the clinical assessments in the areas of cognition, motor, sensory, and perceptual; using the results to assist in determining their driving risk. 
   • The driving instructor’s skills contributed to the development of a road assessment that would be sufficiently challenging and the driving instructor’s vehicle would be used for the on road assessment, as it already has the safety brake on the right side and is highly skilled in the maintaining vehicle safety with novice or medically at risk drivers.
3. The training was successfully in launching two new centers for the MRU to use for determining fitness to drive:  Greenville, NC and Wilmington, NC.
4. The medically at risk driver is evaluated by driving the driving school’s vehicle with the driving instructor in the front seat to maintain vehicular safety and the occupational therapist sits in the back seat, giving the directions, and completing the comprehensive evaluation by observing the driver on the road for approximately 45 minutes. 

As another outcome of this project to develop a toolkit that can be used anywhere.   

A Collaborative Model for the Comprehensive Driving Evaluation:

Purpose: This educational module provides guidelines, resources, protocols and case examples required to provide comprehensive driving evaluations for select clients through a collaborative model of an experienced occupational therapist and licensed driving instructor.    

A Collaborative Model for the Comprehensive Driving Evaluation:  How to Build an Occupational Therapy Driving Program with the Partnership of a Driving Instructor 

The complete Program includes:   

Table 1. Occupational Therapist Essential Knowledge and Skills   

Table 2. Connections Chart Between Performance Skills and Driving Performance 

Table 3. Example of a Driving Route Cue and Sheet for Notes

Table 4. Example of a Comprehensive Driving Evaluation Format

Video Resources